- Phone: (415) 507-0900
- Mailing Address: PO Box K. San Rafael, CA 94903
BAYMARIN COMMUNITY CHURCH CONSENT, RELEASE OF LIABILITY, AND WAIVER AGREEMENT
Parent(s)/Guardian(s): I/We the undersigned Parent(s)/Guardian(s) (hereafter “I”), hereby authorize and consent to my child’s participation and involvement in the activities of BayMarin Community Church, San Rafael, CA (hereafter “the Church”) which shall include but not be limited to: participation in all on and off site events sponsored or organized by or through the Church such as: indoor and outdoor lessons, work, acts of service or goodwill, games, swimming, and sporting activities of any kind (hereafter “Activities”).
I understand that illness and injuries sometimes occur during or through the participation in Activities. In the event of an emergency or if any medical treatment is necessary, I consent to and authorize the transportation of my child to the NEAREST SUITABLE MEDICAL HOSPITAL FACILITY. I herby consent to and authorize emergency or other medical/health/dental treatment of my child as may be deemed advisable in the event of accident, injury, or illness during the Activities of the Church.
I understand that I am solely responsible to select and purchase adequate medical/health/dental insurance. Furthermore, I understand that neither the Church nor the Children’s Ministry, nor the Youth Ministry will provide medical/health/dental insurance. I consent to and authorize that if illness or injury necessities the expenditure of money for medical attention, special travel arrangements, or any other reason deemed necessary by the person in charge of the Activities, that I will be responsible for all costs, including but not limited to any and all examinations, diagnoses, treatments, anesthesia, and surgical treatment of any kind.
I understand that my child must obey the rules, established by the Church, and follow the directions and instructions of the person/people in charge of the Activities. I consent to and understand that the person or agents in charge of the Activities have the right to dismiss my child who is in their opinion a hazard to the safety and well-being of him/herself and/or others, or who appears to have rejected the reasonable guidelines of the Activity. I understand that if my child is sent home under such circumstances, I will be responsible for all associated costs incurred, including the cost of special travel arrangements.
ASSUMPTION OF RISKS- In consideration of the Church allowing me or my child to participate in events, Activities, or travel with the Church and all related activities associated with the Church, including participation in the Children’s and/or Youth Ministry, I acknowledge that I am aware of the possible risks, hazards and dangers associated with participation in the Activities including the possible risk of severe or fatal injury to my child and to others. These risks include but are not limited to the following:
§ Risks associated with traveling to and from Activities by means of private and/or public transportation;
§ Risks associated with failing to follow the instructions or directions of the person/people in charge of the Activities;
§ Risks associated with the participation in the Activities;
§ Risks associated with medical problems arising before, during and following participation in Activities; and
§ Other not mentioned probable and unforeseen risks and/or acts of God.
DISCLAIMER and RELEASE OF LIABILITY - I, for myself or my child, voluntarily accept and fully assume such risks, dangers and hazards and the possibility of personal injury, death, partial or permanent disability, dismemberment, property damage or loss resulting from my or my child’s participation in the Activities. I do hereby forever release, indemnify and hold harmless the Church, its Elders, directors, corporation members, staff, agents, volunteers, members, representatives, any property or land owner or lease holder from:
a) any and all loss, personal injury, accident, misfortune or damage to the above named or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above named;
b) any and all claims, demands, actions and costs for any loss, injury, damage or expense of any kinds (including attorney fees) that might arise out of my or my child’s participation in the Activities; and
c) any and all liability for any damage to the personal property of, or personal injury to, any third party resulting from my or my child’s participation in the Activities.
ACKNOWLEDGEMENT By participating in children’s and youth ministry, I release all claims with respect to copyright ownership and publication, including any claim for compensation related to use of image materials. I understand the Church may in-house publish and print, electronic, or video format the likeness or image of me/my child. The Church will not publish images on its website or social media sites without separate permission.
I understand that my child may be video taped or photographed by others and acknowledge that the Church is not responsible for social media or other publications of any kind. I understand that this is a legal agreement that is binding upon myself, my heirs, executors, administrators, successors and assigns. I acknowledge that I have read and understand the terms of this agreement and acknowledge that by signing this agreement voluntarily, I am agreeing to abide by its terms and I am waiving certain legal rights that I or my child may have. This Consent, Authorization and Acknowledgement shall be effective from and including the date signed.